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OsteoporosisPublished by Bupa's health information team, September 2008. This factsheet is for people who have osteoporosis, or who would like information about it. Osteoporosis literally means "porous bones". It's a condition where bones lose density causing them to become weak and more likely to fracture (break).
How osteoporosis developsAbout osteoporosisAbout one in two women and one in five men over 50 will fracture a bone because of osteoporosis. Osteoporosis can affect all age groups, but it's most common in postmenopausal women. Having osteoporosis doesn't automatically mean that your bones will fracture, it just means that it's more likely. Symptoms of osteoporosisYou can't see or feel your bones getting thinner, and may be unaware of any problems until you fracture a bone or start to lose height. Complications of osteoporosisBroken wrists, hips and spinal bones are the most common fractures in people with osteoporosis. Fractures can, however, occur in any bone. They can result in pain, disability, loss of independence and a drop in self esteem. Causes of osteoporosisHealthy bone consists of a strong mesh made of protein and minerals (particularly calcium). This mesh is living tissue that is constantly being renewed by two types of cells. One type builds up new bone and the other breaks down old bone. Up to our mid-20s our skeleton is strengthened, but from our 40s onwards our bones gradually lose their density as a natural part of ageing.
Our bone health is largely down to the genes we inherit from our parents. However, there are factors that can put you at greater risk of osteoporosis. The breakdown of bone is quicker in women who have been through the menopause. This is because of a lack of the hormone oestrogen. Oestrogen reduces the amount of bone broken down and so helps to protect against osteoporosis. In women, oestrogen is made in the ovaries from puberty until the menopause. Anything that reduces the number of years that a woman produces oestrogen may increase the risk of osteoporosis. These include:
The hormone testosterone has an important effect on bone strength in men. Men with a decreased function of the testicles (hypogonadism) have low levels of testosterone and a greater risk of osteoporosis. Other factors include:
Some medicines and disorders can increase your risk including:
Diagnosis of osteoporosisOsteoporosis is usually diagnosed in hospital, often after a fall or if you fracture a bone. Your doctor will measure your bone density using a dual-energy X-ray absorptiometry (DEXA) scanner. Osteoporosis is diagnosed when bone density is found to be significantly lower than average. Scans are painless and take approximately 10 to 20 minutes. Treatment of osteoporosisSelf-helpIf you have osteoporosis you need to be careful of vigorous, high-impact exercise. However, leading an active lifestyle will improve balance, coordination and develop muscle strength. All these can reduce the risk of falling and fracturing a bone. Beneficial exercise includes swimming, gardening, walking, golf and Tai Chi. Eating a diet rich in calcium is important for maintaining healthy bones. Good sources of calcium include milk and dairy products, such as hard cheese and yogurt, dried apricots or figs and some green leafy vegetables such as watercress and curly kale. Postmenopausal women with osteoporosis should aim to take 1,000mg of calcium every day, either in their diet or as a supplement. This can be obtained from 600ml of milk with either 50g of hard cheese (eg Cheddar or Edam), one pot of yogurt, or 50g of sardines. Your body also needs vitamin D to absorb calcium properly. Vitamin D is found in certain foods, including cod liver oil, oily fish such as sardines and herrings, margarine and egg yolks. It's also made by your skin when you're in the sunlight. The National Osteoporosis Society recommends about 20 minutes of sun exposure to the face and arms, every day during the summer, to provide you with enough vitamin D for the year. However, to reduce your risk of getting skin cancer, you should cover your skin between 11am and 3pm, and don't allow your skin to burn. You should try not to drink fizzy drinks or have too much caffeine, salt or animal protein, as these can affect the balance of calcium in your body. Eating plenty of fruit and vegetables can help to cancel out the effects of too much protein in your diet. MedicinesYour doctor may prescribe the following medicines to help prevent fractures and increase your bone density.
Hormone replacement therapy (HRT) is a prescription-only treatment that relieves symptoms of the menopause by restoring hormones to a premenopausal level. HRT has also been shown to reduce osteoporosis, but you probably won't be prescribed it to treat or prevent the condition. Deciding whether to take HRT is your choice and your GP will discuss the risks and benefits with you. Pain managementIf you fracture a bone, over-the-counter painkillers can help. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice. Physiotherapy, hydrotherapy (exercise in water) and TENS (transcutaneous electrical nerve stimulation) and alternative therapies, like acupuncture, may also help. Always ask your doctor or pharmacist for advice before any treatment. Treatment for menIf your osteoporosis is caused by hypogonadism, your GP may prescribe testosterone replacement therapy. Your doctor may prescribe the bisphosphonates alendronate (eg Fosamax) or risedronate (eg Actonel) to slow down bone loss. Prevention of osteoporosisLifestyle changes could help to reduce your chances of developing osteoporosis. A healthy diet and exercise can increase bone mass, especially in younger people with growing bones. Adults should aim to have 700mg of calcium every day, which you should be able to get through healthy eating. High-impact exercise, where you support your own weight, is best for strengthening bones. The National Osteoporosis Society recommends jogging, aerobics, tennis, weight-training, dancing and brisk walking. If you aren't used to exercising, build up your exercise routine gradually. Talk to your GP before you start a new exercise routine. Smoking can have a harmful effect on your bone strength and can also cause an early menopause. If you smoke, you should try to give up. You should also be careful not to drink too much alcohol. Further information
Related topicsSources
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer-reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: September 2008
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